The Power of Partnering
Beth Ulrich, EdD, RN, CHE

The theme of the 2005 ANNA National Symposium is Partnering with Patients in Self Management: A Winning Combination. Partnering is one of those concepts that, when the topic is brought up in a group, everyone in the group nods sagely and seems to agree that it’s a good concept. Successfully partnering with patients, however, requires a plan of action, commitment to the long-term outcomes, and perseverance.
 
Master Professional
Partnerships First
Before nurses are ready to enter into partnering relationships with patients, they must first learn to partner and collaborate with each other and with other health care professionals. We often talk about partnering and collaboration in nephrology settings, but sometimes what occurs could more accurately be described as cooperating or co-existing.  Professional collaboration goes beyond cooperation. It is, according to the American Nurses Association (ANA), the “concerted efforts of individuals and groups to attain a shared goal” and requires “mutual trust, recognition, and respect among the health care ream, shared decision-making about patient care, and open dialogue among all parties who have and interest in and a concern for health outcomes.” Numerous studies have shown the benefits of professional partnering and collaboration including:

• Improved patient outcomes
• Decreased patient morbidity
• Decreased nurse turnover
• Increased job satisfaction
• Decreased stress and burnout
• Increased autonomy
• Reduced lengths of stay
• Willingness to question orders etc for the good of the patient.

Effective Partnering
In partnering, 1+1=3.  The sum is more than the total of the parts. To be effective, partnering requires:

• The right people partnered together
• A long-term commitment
• Trust
• Planning
  
• Shared goals/outcomes
• A proactive approach
• Creativity
• Understanding each other’s expectations
• Mutual contributions
• Flexibility
• Conflict resolution abilities
• Valuing what each partner contributes
• Mutual respect
• A level playing field
• Sharing knowledge and responsibility.
  

Partnering Is a Challenge
Partnering relationships are harder in many ways than relationships in a clearly defined hierarchy. Partnering is especially difficult for those individuals who highly value control or who don’t have the temperament or the talent to dedicate time to developing the relationship. It’s often easier to be the person in control than to share control or to be the person who knows how to do something and does it rather than the person who takes the time to teach a concept or skill to another.
 
In nephrology, we have long had requirements concerning the involvement of patients in planning their care, but involvement is not defined as “we think you should do this, what do you think?” or a perfunctory signature on an already determined plan of care. It means making it easy and expected for the patient to participate from day one. It means accepting the patient as an equal partner with just as much right to know about the disease and options and just as much right to an opinion. It means being comfortable and supportive with what a patient decides is best, even if it’s not what you’d chose for yourself. It means finding time, which we all have too little of, to talk one-to-one, eye-to-eye, on the same level, and to listen. And finally, for nurses, it means embracing the plans and decisions the patient has made and being an advocate to assure that they are carried out.

RNs As Partners
Registered Nurses have a decided advantage when partnering with patients. For years, the annual Gallup poll on honestly and ethics in professions has found nursing to be rated the highest. Patients and families trust us to be honest and ethical more than they trust any other profession. That is such a treasure and gives us a wonderful head start in establishing partnerships with our patients.

The Power of Partnering
The power of partnering can be a wonderful thing for nurses, patients, and the health care system. If we do it right and do it together, partnering with patients can be the best thing that’s ever happened to either of us.

Beth Ulrich, EdD, RN, CHE
Editor
E-mail: BethUlrich@aol.com